Prostate Cancer: To Treat or Not to Treat?

Feb. 21, 2006

For the more than 232,000 American men diagnosed with prostate cancer every year, choosing a treatment option can be difficult.

That's because there are not only different types of prostate cancer -- some forms are more severe than others -- there are also many types of treatment options, from radiation to surgery to watchful waiting.

To help men sort through these complex issues, ABC News medical editor Dr. Tim Johnson will explore the options this week on "Second Opinion: Prostate Cancer," a World News Tonight series.

How Do You Choose?

So, if you're a man faced with a recent diagnosis of prostate cancer, how do you choose your treatment?

Dr. Durado Brooks, American Cancer Society director of prostate cancer, says the first step is to understand how cancer is staged according to its severity.

"The man should know, for instance, what is found at biopsy," Brooks said. "The biopsy gives information to the man and his treating physician in order to make a decision."

In some cases -- especially if a man has a slow-growing form of cancer or other more severe health conditions -- "watchful waiting" may be all that is necessary. It involves regular exams and blood tests to make sure the cancer isn't spreading faster than predicted.

After learning about the diagnosis, Brooks said, the next step is to research the many treatment options. That can be done through reading books and surfing cancer information web sites.

Seeking a second opinion also is recommended, Brooks said.

"It is recommended that a man talk both to a surgeon and a radiation oncologist so that he gets the perspectives from both of these experts," Brooks said.

That's because several different treatment options may be effective at treating cancer, but all treatments will have different side effects. A man has to choose which side effects he wants to avoid while weighing how effective a treatment will be.

Once the treatment decision is made, the man should then make sure the doctor or treatment center is qualified. To find that out, just ask, Brooks said.

For example, many surgeons compile outcome data, such as whether a man was able to have full urinary function after the surgery.

Above all else, the most important thing to keep in mind is that no two cases are alike. Each man has different and important factors to consider, Brooks said.

"In order for a man to decide the direction he wants to take, he must do some serious research," he said.